Rehabilitation and Tuning Following Cochlear Implant Surgery

This page provides information regarding rehabilitation and tuning for adults following cochlear implant surgery.

Please use the links below (shown in blue) to navigate to the desired section of the page.

 When will my Cochlear Implant be switched on?

In most cases your cochlear implant will be ‘switched on’ three weeks after your surgery. This is to give you time to recover from your surgery and for the wound to heal properly.  There is usually some swelling around the implant site which takes a few weeks to settle down. This is important as it could affect the wearing of the coil or headpiece as sometimes even the strongest magnet is not enough to keep it in place. This would make it difficult for the sound processor to send the signals to the internal part.

 What happens in the switch on appointment?

Appointments usually last for about 60 to 90 minutes. The audiologist will check the implant site. They will also check that the magnet strength for the headpiece or coil is just right. In some cases, a stronger magnet is needed initially, but may be reduced as the scar and swelling settles completely over time.

Your external sound processor will then be connected to the computer which allows the audiologist to start tuning. The audiologist carries out a quick test of the electrodes first to make sure that these are all working fine. There are occasions, although rare, where electrodes will have to be disabled if they show unusual activity. If this occurs, your audiologist will explain this to you in more detail.

Once this is done, the audiologist starts the mapping or tuning. This is the process of converting acoustical speech signals into electrical stimulation. To measure this, the stimulation will be presented as beeps where you will either be asked to count the number of beeps that you hear or to rate their loudness. Once this is established, the audiologist will then switch it on to live mode.

To start with, what you hear may just be noises. It will take a while for your brain to adapt to the sound of your cochlear implant. During the first session, even a small amount of stimulation usually sounds loud. Your levels will gradually increase over time as you get used to your implant. As the levels increase, the sound quality usually improves.

What happens after the switch on appointment?

You will see the audiologist for further ‘tuning’ appointments and a member of the rehabilitation team (usually your keyworker) for rehabilitation sessions.

How often do I need to see the audiologist for tuning?

This will vary for every patient, depending on how quickly the levels stabilise but you should expect to have more frequent tunings within the first year of having a cochlear implant.

However, the standard guideline we follow is as below:

1st tuning (switch-on) = three weeks after surgery
2nd tuning = One week after switch-on
3rd tuning = Two weeks after 2nd tuning
3 month review = Two months after 3rd tuning
6 month review = Three months after 4th tuning
12 month review = Six months after 5th tuning
24 month review = Either six months or one year after 6th tuning

The number and frequency of your tuning appointments will depend on clinical need which will be decided by your audiologist. Some patients may require more tuning appointments than others to ensure that the levels are always set to maximise benefit.

Once the audiologist is satisfied with the stability of your map / tuning, you will no longer be required to attend tuning appointment unless you have any problems with your cochlear implant. However, we will continue to support you in maintaining your equipment as needed.

What is involved in the rehabilitation sessions?

The aim of these sessions is to help you get the maximum benefit from your cochlear implant. We will set appropriate aims for each session and may give you work to do at home to achieve these aims. Some of the things we may do in these sessions would include tasks like:

  • Listening to speech in quiet and noise
  • Introduction to environmental sounds
  • Counselling and support
  • Use of environmental aids such as loop systems, telephone practice.

How many rehabilitation sessions do I have?

Everyone will have a minimum of seven sessions in the first year of implantation and these are at set times. Obviously everyone is different and you may need to attend more rehabilitation sessions but your keyworker will discuss this with you.

What do I do if I have any problems?

For any queries or concerns about your cochlear implant, please contact us in the office and we will try our best to answer your questions.

Please do not just turn up as it is likely that all the audiologists will be busy with other patients and will not be able to see you.

Bimodal hearing

If you have one cochlear implant, there may be a compatible hearing aid that you can use in your other ear. Your audiologist will discuss this with you if it’s appropriate.